Matthew Michaels, MD

Matthew Michaels, MD, FAAPM&R

Dr. Michaels specializes in Physical Medicine and Rehabilitation (PM&R), a combination of non-surgical orthopedics and neurology. As a PM&R physician (physiatrist) he is trained to put the emphasis on function. His goal is to help RestorePDX patients return to living life and doing the things they want and need to do.

His practice methods are heavily influenced by his personal history of chronic back pain and by his athletic background. He is an ironman triathlete, and a double black diamond downhill skier.

His goal in treatment is to educate regarding the root causes of the individual’s pain so they will have the tools to treat themselves as much as possible. He wants to, “give you the tools you need, so you will need our help less often.”

His focus is on painful conditions of the bones, joints, muscles, nerves and connective tissue, with a primary emphasis on painful conditions of the spine, including neck pain and headaches, low back and leg pain (sciatica).
He has pursued extensive training and has experience in fluoroscopic and ultrasound-guided interventional spinal procedures, nerve blocks, epidural steroid injections and spinal joint injections. These techniques are employed as a part of a comprehensive integrative program of therapy, education and exercise. Specifically, injections are used to diagnose and to facilitate the primary intervention which is physical therapy.

What is the Tenex procedure?

Tenex percutaneous tenotomy is a breakthrough technology that allows us to treat painful tendon problems in a way that was not possible before the development of the Tenex needle.

The Tenex percutaneous tenotomy procedure is a minimally invasive “band aid” procedure generally performed in an Ambulatory Surgery Center under IV conscious sedation

The condition that we are treating is referred to as Tendinosis. The TENEX needle is a blunt 14 gauge needle that vibrates at 26,000 Hz or cycles per second. This vibration loosens damaged tissue while the needle is also circulating saline water through the area. The saline facilitates removal of the loosened tissue.

What conditions is TENEX for?

Tenex percutaneous tenotomy is used to treat chronically painful tendon problems including but not limited to the following locations and conditions:

Rotator cuff tendinosis

Tennis elbow

Golfer’s elbow

Achilles tendonosis

Patellar tendonosis

Hip tendonosis

Why don’t we use the term tendinitis anymore?

Tendinosis is the term we now use to describe what was called tendinitis in the past. We now understand the painful tendon problems are generally not caused by inflammation of the tendon, but are caused by progressive degeneration of the tendon over years. For this reason, the suffix – “itis” – which refers to an inflammatory condition – generally does not apply to tendon pain. This is also the reason that steroid injections tend to be of very limited benefit for tendon pain, and can cause the condition to worsen if they are repeated over time.

What is Tendinosis?

Tendinosis is a painful degeneration of tendon that occurs when the stress and repeated injury of a tendon is not balanced by appropriate healing. This imbalance of injury vs healing overwhelms the tendon with weakened fibers and new blood new blood vessels that form to heal the injury. The degraded tissue and new blood vessels become a barrier to healing.

Why do tendons degenerate?

Tendons are under enormous stress every day and are therefore prone to frequent minor injuries. Each of these minor injuries tend to be inconsequential. But tendons also have a very poor blood supply and therefore do not heal rapidly or completely. As a result, the injuries add up over time until the tendon is simply too weak to function normally. At this point the weak tendon may simply become painful but, in some people the body will deposit calcium in the tendinosis to try to strengthen the tendon. This is called calcific tendinopathy.

What will Tenex do for me?

The Tenex procedure removes the damaged tissue associated with tendinosis and sets the table for healing to occur.

What is the recovery time for Tenex?

Healing time after Tenex is usually 4-6 weeks, but can be longer
Is there any way to speed up the recovery time?
We have found that the addition of the Orthobiologc (regenerative) product Amniofix can significantly reduce recovery time and improve the outcome of the procedure.